Mesut OZGOKCE, Nuri HAVAN, Süleyman KARABACAK, Ayşe HAVAN, İlyas Dündar, Fatma DURMAZ, İbrahim ÜNEY, HANİFİ YILDIZ, Sümeyra DEMİRKOL ALAGÖZ, Harun ASLAN

Orta lob sendromlu olgularda bilgisayarlı tomografi bulguları

Amaç: Orta lob sendromu (OLS), sağ akciğer orta lobunun kronik veya tekrarlayan atelektazileri ile karakterize bir tablodur. Spesifik bir klinik bulgusu yoktur. OLS tanısında Bilgisayarlı Tomografi (BT) en sık kullanılan modalitedir. Kliniğimizde son iki yılda OLS tanısı almış hastaların BT bulgularını literatür eşliğinde sunmayı amaçladık. Gereç ve Yöntem: Mayıs 2015- Mayıs 2017 tarihleri arasında hastanemiz radyoloji kliniğine başvuran ve OLS tanısı alan 29 hastanın, BT ve klinik bulguları retrospektif olarak iki radyolog ve bir göğüs hastalıkları uzmanı tarafından incelendi. Bulgular: OLS tanısı alan 29 hastanın 17’si (%58,6) kadın, 12’si (%41,4) erkek hastaydı. Kadın/erkek oranı 1.42 idi. Bu olguların yaş ortalaması ise 59,4±17,01 (8-84 yaş) olarak hesaplandı. Klinik değerlendirmede en sık semptom öksürük, nefes darlığı ve balgam olarak saptandı. Radyolojik görüntülemede tüm hastaların BT tetkiklerinde sağ akciğer orta lobda atelektazi mevcuttu. Atelektazi ile birlikte diğer en sık eşlik eden bulgular ise 11 hastada mediastinal ve/veya hiler patolojik görünümde lenfadenopati, 6 hastada bronşektazi, 4 hastada enfeksiyon ile uyumlu parankimal bulgular, 3 hastada parankimal nodüller, 3 hastada peribronşial kalınlaşma, 2 hastada operasyon sonrası değişiklikler, 2 hastada diafragmaevantrasyonu, 2 hastada mukus tıkacı, 1 hastada squamöz hücreli kanser, 1 hastada da pulmoneremboli idi. Dört hastada herhangi bir ek akciğer patolojisi saptanmadı. Sonuç: OLS, sağ akciğer orta lobun total atelektazisi olup spesifik klinik bulguları olmaması nedeniyle kronik ve tekrarlayan akciğer şikayetleri olan her hastada özellikle sağ akciğerde yerleşim gösteren lezyonlarda ayırıcı tanılar arasında göz önünde bulundurulmalıdır. BT’nin rutine girmesi ile de radyolojik olarak görülme sıklığı artmıştır. BT, OLS tanısında etkin ve noninvaziv bir görüntüleme yöntemidir.

Objective: Middle lobe syndrome (MLS) is a condition characterized by chronic or recurrent atelectasis of the right middle lobe of the lung. There is nonspecific clinical finding. Computed Tomography (CT) is the most commonly used modality in MLS diagnosis. We Aimed To Present The CT findings of : patients who have been diagnosed MLS in our clinic for the past two years with literature. Materials and Method: Between May 2015 and May 2017, CT and clinic findings of 29 patients who are diagnosed MLS reviewed retrospectively by two cardiologist and a chest diseases doctor. Results: 17 of the 29 patients (58,6%) were female and 12 (41,4%) were male who are diagnosed with MLS. Female/male ratio was 1,42. The Mean Age of these cases was 59,4 ± 17,01 (8-84 age range). In Clinical Assessment The Most Common Symptoms Were Cough, shortness ofbreath and sputum. Radiologically, all patients had atelectasis in the right middle lobe of lung at the CT examination. The Most Common Accompanying Findings with atelectasis were mediastinum and/or hilar lymphadenopathy in 11 patients, bronchiectasis in 6 patients, parenchymal findings compatible with infection in 4 patients. Any Lung Pathology Wasn't detected in 4 patients. Conclusion: MLS is a total atelectasis of the middle lobe of right lung and there is nonspecific clinical findings. İt Should be absolutely considered among the differential diagnosis in patients with chronic and recurrent lung complaints, especially in the located lesions that in right lung. The frequency of radiological appearance increased with the routinizing of CT. CT is an effective and non-invasive imaging method for diagnosis of MLS.

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